The Reverse Stroke project is developing a breakthrough Brain‑Spine Interface (BSI)
‍designed to help restore hand and arm movement for people living with stroke‑related paralysis.

This project is funded by European Innovation Council (Horizon-EIC-2024-PathfinderOpen-01 ReverseStroke n°101187647) and the Swiss State Secretariat for Education, Research and Innovation (SERI)

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overview

From violinists to metal welders, finely tuned hand and arm movements are the foundation of craft, while all of us rely on proficient use of hands for the activities of daily life. Yet, more than 25 million people worldwide lost functional movements to subcortical stroke.



Subcortical stroke often interrupts the communication between the cortex and the cervical spinal cord circuits, which leads to permanent hand and arm paralysis. The result is a vastly reduced quality of life and enormous socioeconomic burden for the affected, their families, and the society. A treatment that can effectively restore functional movements after subcortical stroke does not yet exist. Still, the motor cortex, which orchestrates movements, and the spinal cord motor circuits that directly control muscles remain largely intact. We aim to reverse the hand and arm paralysis of people with subcortical stroke by developing a digital bridge that reconnects the motor cortex with the cervical spinal motor circuits. This brain-spine interface consists of fully-implantable recording and stimulation systems that link cortical signals to spatiotemporal sequences of epidural electrical stimulation targeting spinal cord regions involved in the production of hand and arm movements. Our preliminary results in people with spinal cord injury strongly indicate that the brain-spine interface can restore natural control of movement and promote neurological recovery. Therefore, we are confident that a cervical brain-spine interface can reverse hand and arm paralysis incurred by stroke and, therefore, become a viable treatment option for subcortical stroke survivors.

Our research consortium will now leverage these important breakthroughs to develop a prototype brain-spine interface (BSI) that is intended to link movement intention decoded from the brain's motor cortex to a novel spinal cord stimulation system that promotes the intended movements.
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The consortium has previously demonstrated that <> in the EIC funded project ReverseParalysis

(EIC 2021-TransitionChallenges-01-01 ReverseParalysis n°101057450
The BSI system used in these preliminary demonstrations was comprised of technology not initially intended for this purpose, thus presenting shortcomings.

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Julien Camisani
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ONWARD Medical N.V., Principal Investigator
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Julien Camisani
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ONWARD Medical N.V., Principal Investigator
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Guillaume Charvet
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CEA Leti Clinatec (France), Co-Investigator
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Guillaume Charvet
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CEA Leti Clinatec (France), Co-Investigator
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Grégoire Courtine, PhD
Professor of Neurosciences
EPFL - École polytechnique fédérale de Lausanne (Switzerland), Co-Investigator
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Grégoire Courtine, PhD
Professor of Neurosciences
EPFL - École polytechnique fédérale de Lausanne (Switzerland), Co-Investigator
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Davy Luneau
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Dessintey
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Davy Luneau
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Dessintey
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Dr. Christian Wende, LL.M.
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DTS Patent and Trademark Attorneys (Germany)
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Develop Clinical Assessment
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Develop Clinical Assessment
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Head of Neurosurgery Department
CHUV
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Prof. Dr. Jocelyne Bloch
Head of Neurosurgery Department
CHUV
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Assistant Professor
UNIL
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Assistant Professor
UNIL
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EPFL
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Friedhelm Hummel, MD
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EPFL
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Graylight Imaging
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Ethics and integrity of the activities funded by the EU

In addition to the scientific evaluation focusing on the scientific merit, the quality of the management, and the potential impact, the Ethics Appraisal promoted by the EU ensures that all research activities carried out under Horizon Europe are conducted in compliance with fundamental ethical principles. For all activities funded by the EU, the ethical dimension is an integral part of research from beginning to end, and ethical compliance is seen as pivotal to achieve real research excellence, in particular for neurotechnology and the potential utilization of artificial intelligence (AI). There is a clear need to make a thorough ethical evaluation from the conceptual stage of the proposal not only to respect the legal framework but also to enhance the quality of the research. Ethical research conduct implies the application of fundamental ethical principles and legislation to scientific research in all possible domains of research. This includes the adherence to the highest standards of research integrity as described in the European Code of Conduct for Research Integrity. The process to assess and address the ethical dimension of activities funded under Horizon Europe is called the Ethics Appraisal Procedure and it is conducted all along the conduct of the research projects. To this end, in order to further promote the development of an ethical awareness among members of the Reverse-Stroke consortium as well as the general public, further references are provided here below. These will allow the reader, on the one hand, to better know how the EU ensures that all research activities carried out within the framework of Horizon Europe are done in compliance with fundamental ethical principles and, on the other hand, to become more familiar with the specific ethical issues raised by this kind of breakthrough project. Hence, the concepts developed in the proposed references will allow the reader to better grasp the kind of ethical reflections to be pursued in the development of new neurotechnologies, in particular those using either machine learning or artificial intelligence applied to brain-computer interfaces.
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